Effects of cognitive behavioral therapy with relaxation vs. imagery rescripting on test anxiety: A randomized controlled trial.

Background: Test anxiety is a common condition in students, which may lead to impaired academic performance as well as to distress. The primary objective of this study was to evaluate the effectiveness of two cognitive-behavioral interventions designed to reduce test anxiety. Test anxiety in the participants was diagnosed as social or specific phobia according to DSM-IV. Subsequently subjects were randomized to three groups: a moderated self-help group, which served as a control group, and two treatment groups, where either relaxation techniques or imagery rescripting were applied.

Methods: Students suffering from test anxiety were recruited at two German universities (n=180). The randomized controlled design comprised three groups which received test anxiety treatment in weekly three-hour sessions over a period of five weeks. Treatment outcome was assessed with a test anxiety questionnaire, which was administered before and after treatment, as well as in a six-month follow-up.

Results: A repeated-measures ANOVA for participants with complete data (n=59) revealed a significant reduction of test anxiety from baseline to six-month follow-up in all three treatment groups (p<.001).

Limitations: Participants were included if they had a clinical diagnosis of test anxiety. The sample may therefore represent only more severe forms of text anxiety . Moreover, the sample size in this study was small, the numbers of participants per group differed, and treatment results were based on self-report. Due to the length of the treatment, an implementation of the group treatments used in this study might not be feasible in all settings.

Conclusions: Group treatments constitute an effective method of treating test anxiety, e.g. in university settings. Imagery rescripting may particularly contribute to treatment efficacy.